Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/18053
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dc.contributor.authorSood, Siddharth-
dc.contributor.authorHaifer, C-
dc.contributor.authorYu, L-
dc.contributor.authorPavlovic, J-
dc.contributor.authorGow, Paul J-
dc.contributor.authorJones, Robert M-
dc.contributor.authorVisvanathan, Kumar-
dc.contributor.authorAngus, Peter W-
dc.contributor.authorTestro, Adam G-
dc.date2018-05-29-
dc.date.accessioned2018-07-10T06:34:24Z-
dc.date.available2018-07-10T06:34:24Z-
dc.date.issued2018-05-29-
dc.identifier.citationTransplant infectious disease : an official journal of the Transplantation Society 2018; 20(5): e12934-
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/18053-
dc.description.abstractAlthough antiviral prophylaxis is effective in preventing early cytomegalovirus (CMV) reactivation following liver transplantation (OLT), it predisposes patients to late CMV after prophylaxis has ceased. QuantiFERON-CMV (QFN-CMV, Qiagen, The Netherlands) measures an individual's viral-specific immune response. Fifty-nine OLT recipients were prospectively monitored post-OLT in an observational cohort study. QFN-CMV was performed at regular time-points. An absolute QFN-CMV <0.1 IU/mL was considered non-reactive. 50/59 (84.7%) had a reactive QFN-CMV by M6. 38/59 (64.4%) had antiviral prophylaxis or treatment before M6, with 31/38 (81.6%) developing a reactive QFN-CMV by 6 months. Over 90% already had a reactive result as early as 3 months post transplant, 3 patients (5.08%) developed late CMV between 6-12 months (median 251 days)-all had a non-reactive M6 QFN-CMV. And 2/3 experienced CMV disease. Non-reactive M6 QFN-CMV was significantly associated with late CMV (OR = 54.4, PPV = 0.33, NPV = 1.00, P = .003). Although only 5% of recipients developed late CMV, 2/3 suffered CMV disease. M6 QFN-CMV has an excellent NPV for late CMV, suggesting patients who exhibit a robust ex vivo immune response at M6 can safely cease CMV monitoring. Furthermore, >90% already express viral-specific immunity as early as 3 months. Conceivably, antiviral prophylaxis could be discontinued early in these patients.-
dc.language.isoeng-
dc.subjectCMV disease-
dc.subjectQFNCMV-
dc.subjectcytomegalovirus-
dc.subjectlate CMV-
dc.subjectliver transplantation-
dc.subjectquantiferon-CMV-
dc.titleEarly viral-specific T-cell testing predicts late cytomegalovirus reactivation following liver transplantation.-
dc.typeJournal Article-
dc.identifier.journaltitleTransplant infectious disease : an official journal of the Transplantation Society-
dc.identifier.affiliationVictorian Liver Transplant Unit, Austin Health, Heidelberg, Victoria, Australia-
dc.identifier.affiliationDepartment of Gastroenterology & Hepatology, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia-
dc.identifier.affiliationInnate Immune Laboratory, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia-
dc.identifier.doi10.1111/tid.12934-
dc.identifier.orcid0000-0002-9341-4792-
dc.identifier.pubmedid29809312-
dc.type.austinJournal Article-
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